Document Detail


Hemodynamic effects of dexmedetomidine sedation for CT imaging studies.
MedLine Citation:
PMID:  18363628     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dexmedetomidine sedation for radiological imaging studies is a relatively recent application for this drug. Previous studies have demonstrated some haemodynamic effects of dexmedetomidine, however, the effects remain poorly described in children. The aim of this study was to better define the effect of age on heart rate (HR) and blood pressure changes in children sedated for CT imaging with dexmedetomidine. METHODS/MATERIALS: At our institution dexmedetomidine is given for sedation for CT imaging as a bolus of 2 mcg.kg(-1) over 10 min followed by an infusion of 1 mcg.kg(-1).h(-1) with a second bolus if required. Detailed quality assurance data sheets document patient demographics, sedation outcomes, adverse events, and hemodynamic data are recorded for each patient. RESULTS: A total of 250 patients (range 0.1-10.6 years) received dexmedetomidine. ANOVA revealed strong evidence for changes in HR and mean arterial blood pressure during bolus and infusion relative to presedation values (P < 0.001). These changes were apparent in each age group and similar between groups. During the first bolus and during infusion, 82% and 93% of patients respectively were within the age-based normal range for HR. For mean arterial blood pressure, 70% of patients were within the normal range during first bolus and 78% during infusion. CONCLUSION: In the pediatric population studied, intravenous dexmedetomidine sedation was associated with modest fluctuations in HR and blood pressure. Hemodynamic changes were independent of age, required no pharmacologic interventions and did not result in any adverse events. By anticipating these possible hemodynamic effects and avoiding dexmedetomidine in those patients who may not tolerate such fluctuations in HR and blood pressure, dexmedetomidine is an appropriate sedative for children undergoing CT imaging.
Authors:
Keira P Mason; Steven E Zgleszewski; Randy Prescilla; Paulette J Fontaine; David Zurakowski
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-03-18
Journal Detail:
Title:  Paediatric anaesthesia     Volume:  18     ISSN:  1460-9592     ISO Abbreviation:  Paediatr Anaesth     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-03     Completed Date:  2008-04-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206575     Medline TA:  Paediatr Anaesth     Country:  France    
Other Details:
Languages:  eng     Pagination:  393-402     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Children's Hospital Boston, Harvard Medical School, Longwood Avenue, Boston, MA 02115, USA. keira.mason@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects*
Child
Child, Preschool
Conscious Sedation*
Dexmedetomidine / administration & dosage,  contraindications,  pharmacology*
Female
Heart Rate / drug effects*
Humans
Hypnotics and Sedatives / administration & dosage,  contraindications,  pharmacology*
Infant
Infant, Newborn
Infusions, Intravenous
Male
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 113775-47-6/Dexmedetomidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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